Dr. Robert Lustig

So if your visceral fat accumulates and you start breaking down that fat vacuole and the grease starts spilling and the macrophages start coming in, Those cytokines are going to be at much higher concentration because they only have to populate the portal system, the portal vein, from the gut to the liver. There are two portal systems in your body. What's a portal system?

Exactly. So that's right. What does it drain? So normally... The way blood goes in your body, it goes heart, aorta, artery, organ, vein, vena cava, heart. Okay. That's called a systemic circulation. A portal circulation goes like this, heart, aorta, Artery 1, organ 1, artery 2, organ 2, vena cava, heart. So the blood has to go through two organs to come back to the heart.

Exactly. So that's right. What does it drain? So normally... The way blood goes in your body, it goes heart, aorta, artery, organ, vein, vena cava, heart. Okay. That's called a systemic circulation. A portal circulation goes like this, heart, aorta, Artery 1, organ 1, artery 2, organ 2, vena cava, heart. So the blood has to go through two organs to come back to the heart.

Exactly. So that's right. What does it drain? So normally... The way blood goes in your body, it goes heart, aorta, artery, organ, vein, vena cava, heart. Okay. That's called a systemic circulation. A portal circulation goes like this, heart, aorta, Artery 1, organ 1, artery 2, organ 2, vena cava, heart. So the blood has to go through two organs to come back to the heart.

And there's information being carried from organ 1 to organ 2, which tells organ 2 what to do. So there are two portal systems in the body. One is the hypothalamus to pituitary. We know why that is because that runs all the different hormonal systems of the body. And the other one's pancreas to liver because the liver is the primary target of insulin action.

And there's information being carried from organ 1 to organ 2, which tells organ 2 what to do. So there are two portal systems in the body. One is the hypothalamus to pituitary. We know why that is because that runs all the different hormonal systems of the body. And the other one's pancreas to liver because the liver is the primary target of insulin action.

And there's information being carried from organ 1 to organ 2, which tells organ 2 what to do. So there are two portal systems in the body. One is the hypothalamus to pituitary. We know why that is because that runs all the different hormonal systems of the body. And the other one's pancreas to liver because the liver is the primary target of insulin action.

And so when the liver gets fat, the pancreas has to make more insulin to make the liver do its job. And because the liver gets fat and because it's at the end of that portal system, the Liver doesn't have to get very sick for the pancreas to start making extra insulin and causing problems. Now, the question is, where did the visceral fat come from? Did it come from the diet? No.

And so when the liver gets fat, the pancreas has to make more insulin to make the liver do its job. And because the liver gets fat and because it's at the end of that portal system, the Liver doesn't have to get very sick for the pancreas to start making extra insulin and causing problems. Now, the question is, where did the visceral fat come from? Did it come from the diet? No.

And so when the liver gets fat, the pancreas has to make more insulin to make the liver do its job. And because the liver gets fat and because it's at the end of that portal system, the Liver doesn't have to get very sick for the pancreas to start making extra insulin and causing problems. Now, the question is, where did the visceral fat come from? Did it come from the diet? No.

People think that belly fat is from the diet. No. This is the big, you know, mistake. Yeah, where does it come from? Stress. And the reason we know that is because you can take people who are chronically depressed, who are suicidal, who basically have to be admitted to the hospital to keep themselves from killing themselves. And you put them in a scanner and they're not eating.

People think that belly fat is from the diet. No. This is the big, you know, mistake. Yeah, where does it come from? Stress. And the reason we know that is because you can take people who are chronically depressed, who are suicidal, who basically have to be admitted to the hospital to keep themselves from killing themselves. And you put them in a scanner and they're not eating.

People think that belly fat is from the diet. No. This is the big, you know, mistake. Yeah, where does it come from? Stress. And the reason we know that is because you can take people who are chronically depressed, who are suicidal, who basically have to be admitted to the hospital to keep themselves from killing themselves. And you put them in a scanner and they're not eating.

And so they're losing weight. Hallmark of depression, losing weight. and their subcutaneous fat is going down and their visceral fat is going up. They're losing weight and their visceral fat is going up because cortisol, the stress hormone, is the driver of that visceral fat.

And so they're losing weight. Hallmark of depression, losing weight. and their subcutaneous fat is going down and their visceral fat is going up. They're losing weight and their visceral fat is going up because cortisol, the stress hormone, is the driver of that visceral fat.

And so they're losing weight. Hallmark of depression, losing weight. and their subcutaneous fat is going down and their visceral fat is going up. They're losing weight and their visceral fat is going up because cortisol, the stress hormone, is the driver of that visceral fat.

Absolutely.

Absolutely.

Absolutely.

So we did the opposite at UCSF. We did a study where we took patients with exactly that situation and taught them mindfulness. So yeah, can you explain what that study was? What was the condition?